Human Pathology via MedWorm.com

On being a pathologist—passing on the torch of knowledge

Human Pathology — Sat, 21 Jan 2012 05:03:59 +0100

Ours was a family that valued education. My father, Herman Moe Roth, was an engineer and physicist. Before marriage, my mother, Blanche Brown, was a high school English teacher in Canadian, Oklahoma, a small rural town in the southeastern part of the state. She had studied at Washington University in St. Louis for a year and then completed her education at the University of Oklahoma in Norman. My father obtained his undergraduate degree in electrical engineering from the University of Virginia in Charlottesville. He earned his PhD in astrophysics at the Mendenhall Laboratory of Physics of Ohio State University in Columbus during the great depression. He was the only surviving boy among 7 children and used to joke that he got the education and his sisters each got a dowry. Before World War ...

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Human Pathology — Sat, 21 Jan 2012 05:03:59 +0100

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Human Pathology — Sat, 21 Jan 2012 05:03:59 +0100

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Human Pathology — Sat, 21 Jan 2012 05:03:59 +0100

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Human Pathology — Sat, 21 Jan 2012 05:03:59 +0100

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Human Pathology — Sat, 21 Jan 2012 05:03:59 +0100

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Necrosis assessment in renal carcinoma—reply

Human Pathology — Tue, 13 Dec 2011 18:20:43 +0100

We thank de Bazelaire et al for their interest in our article and appreciate the opportunity to discuss the role of tumor necrosis in renal cell carcinoma. Tumor necrosis is often present in renal cell carcinomas. It is generally believed that tumor necrosis occurs when the blood supply cannot meet a tumor's rapid growth, reflecting aggressive biologic behavior. Several studies have found that the presence of tumor necrosis in renal cell carcinoma is closely associated with high tumor stage and poor prognosis . However, there is also conflicting evidence on whether tumor necrosis can provide any additional prognostic information beyond that of tumor grade and stage. Recent studies have found that the extent of tumor necrosis may provide more accurate prognostic information than simple pre...

Necrosis assessment in renal carcinoma

Human Pathology — Tue, 13 Dec 2011 18:20:43 +0100

We have read with interest the article by Dr Si et al reporting the clinical and pathologic features of 14 renal small cell carcinoma from 2 institutions. The tumors had a mean size of 7.1 cm and were extremely aggressive, with perinephric adipose tissue invasion at the time of diagnosis in 13 of the 14 patients. Interestingly, tumor necrosis was observed in all cases and ranged from 10% to 50% of the tumor area. (Source: Human Pathology)

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Human Pathology — Tue, 13 Dec 2011 18:20:43 +0100

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Human Pathology — Tue, 13 Dec 2011 18:20:43 +0100

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Human Pathology — Tue, 13 Dec 2011 18:20:43 +0100

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Human Pathology — Tue, 13 Dec 2011 18:20:43 +0100

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Human Pathology — Tue, 13 Dec 2011 18:20:43 +0100

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Erythroid proliferations in myeloid neoplasms

Human Pathology — Mon, 12 Dec 2011 05:00:00 +0100

Summary: Prominent erythroid proliferations (in which erythroid elements comprise ≥50% of total bone marrow cells) can be seen in various hematopoietic stem cell neoplasms. The myeloproliferative neoplasm polycythemia vera exhibits effective, overexuberant erythropoiesis resulting in an increased red blood cell mass; in contrast, most other diseases characterized by erythroid predominance exhibit ineffective hemopoiesis. The latter include acute erythroid leukemia (erythroid-myeloid and pure erythroid leukemia subtypes) as well as some cases of myelodysplastic syndromes, acute myeloid leukemia with myelodysplasia-related changes, and therapy-related myeloid neoplasms. Some nonneoplastic reactive conditions may also manifest a striking bone marrow erythroid predominance. In this article, ...

Acknowledgment of reviewers

Human Pathology — Sun, 13 Nov 2011 17:11:16 +0100

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Human Pathology — Sun, 13 Nov 2011 17:11:16 +0100

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Human Pathology — Sun, 13 Nov 2011 17:11:16 +0100

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Human Pathology — Sun, 13 Nov 2011 17:11:16 +0100

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Human Pathology — Sun, 13 Nov 2011 17:11:16 +0100

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In this Issue - November 2011

Human Pathology — Wed, 19 Oct 2011 03:38:58 +0100

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Human Pathology — Wed, 19 Oct 2011 03:38:58 +0100

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Human Pathology — Wed, 19 Oct 2011 03:38:58 +0100

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Human Pathology — Wed, 19 Oct 2011 03:38:58 +0100

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Human Pathology — Wed, 19 Oct 2011 03:38:58 +0100

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In This Issue

Human Pathology — Thu, 29 Sep 2011 18:16:15 +0100

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Human Pathology — Thu, 29 Sep 2011 18:16:15 +0100

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Human Pathology — Thu, 29 Sep 2011 18:16:15 +0100

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Human Pathology — Wed, 14 Sep 2011 04:00:00 +0100

This is an excellent book that deals with recent advances in Lung Cancer, covering this subject under six sections – Overview of lung cancer, Histopathology, Imaging, Molecular pathology, Staging and Preneoplastic and preinvasive lesions. Different chapters in each of these six sections further elaborate on individual topics under consideration with smooth transitions, incorporating the current state of knowledge. Integrating the sections of Imaging, Molecular Pathology and Staging in this book, emphasizes the multimodality approach that is currently used in treating lung cancer. (Source: Human Pathology)

High nuclear protein kinase Cθ expression may correlate with disease recurrence and poor survival in oral squamous cell carcinoma

Human Pathology — Tue, 16 Aug 2011 04:00:00 +0100

This study examined the expression of protein kinase Cθ and assessed its significance in patients with oral squamous cell carcinoma. Immunohistochemical staining was carried out to investigate the expression of protein kinase Cθ in 59 cases of oral squamous cell carcinoma. The results were correlated with clinical characteristics and outcome of patients. Diffuse cytoplasmic protein kinase Cθ was identified in 53 (89.8%) of the 59 oral squamous cell carcinoma cases, and the expression was not statistically associated with any clinicopathologic parameter. Twenty (40.7%) of the 59 oral squamous cell carcinoma cases exhibited nuclear expression of protein kinase Cθ with different grade of intensity. χ2 analysis indicated that high nuclear protein kinase Cθ expression correlated significa...

Liver hemangiomas and elevated serum α-fetoprotein: unsolved questions—reply

Human Pathology — Fri, 12 Aug 2011 23:56:09 +0100

Thank you for allowing us the opportunity to respond to the letter to the editor submitted by Bell et al in response to our article in this journal. We appreciate and agree with the points regarding the view that use of the term liver hemangioma minimizes the chance of confusion with other adult endothelial tumors more so than does our use of “infantile hemagioendothelioma (IHE)”of the liver . IHE was adopted in the World Health Organization (WHO) classification of tumors in 2000 . “Hemangioma of infancy” has been adopted by the WHO for the skin , whereas IHE has been reserved for the liver because of the presence of histologically more aggressive type of IHE and occasional reports of transformation of hepatic IHE to angiosarcoma . However, the terminology and concept of this enti...

Liver hemangiomas and elevated serum α-fetoprotein: unsolved questions

Human Pathology — Fri, 12 Aug 2011 23:56:09 +0100

We read with interest the report by Kim and colleagues in which the authors credibly explained the phenomenon of elevated serum α-fetoprotein (AFP) in 2 infants with hepatic infantile hemangioma. The source of AFP, as demonstrated immunohistochemically, was the hepatocytes located near or entrapped within the tumor. (Source: Human Pathology)

S-100P, von Hippel-Lindau gene product, and IMP3 serve as a useful immunohistochemical panel in the diagnosis of adenocarcinoma on endoscopic bile duct biopsy—reply

Human Pathology — Fri, 12 Aug 2011 23:56:08 +0100

We would like to thank Drs Riener and Kristiansen for their interest in our article and would like to apologize for our inadvertent negligence of not citing their excellent study . We were pleased to learn that, of their 115 cases of surgically resected bile duct carcinomas, 67 (58.3%) showed strong IMP3 (the insulinlike growth factor-II mRNA binding protein-3) immunoreactivity. In contrast, bile ducts with normal histology, acute inflammation, or reactive epithelial changes were negative or only weakly positive for IMP3. These data reaffirm our observations that IMP3 is a useful diagnostic immunomarker that can aid in the distinction between benign and malignant biliary epithelial lesions. Although our study was focused on endoscopic biopsies of the extrahepatic bile ducts, the cases exam...

In This Issue September 2011

Human Pathology — Fri, 12 Aug 2011 23:55:55 +0100

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Human Pathology — Fri, 12 Aug 2011 23:55:55 +0100

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Human Pathology — Fri, 12 Aug 2011 23:55:55 +0100

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Human Pathology — Fri, 12 Aug 2011 23:55:55 +0100

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Human Pathology — Fri, 12 Aug 2011 23:55:55 +0100

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Cytogenetic and comparative genomic hybridization studies of an esophageal giant fibrovascular polyp: a case report

Human Pathology — Thu, 11 Aug 2011 04:00:00 +0100

We present the pathologic and cytogenetic findings of an 18-cm esophageal giant fibrovascular polyp in a 49-year-old woman who presented with odynophagia and dysphagia. The histologic findings are that of classic esophageal giant fibrovascular polyp as previously described in the literature. Cytogenetic study revealed an abnormal karyotype, and comparative genomic hybridization analysis showed regional amplifications of chromosomes 3 and 12 and a possible loss of 22q13.3-qter. The significance of these cytogenetic findings is unclear but may suggest a neoplastic process in the pathogenesis of esophageal giant fibrovascular polyps. (Source: Human Pathology)

Prognostic role of metastasis tumor antigen 1 in patients with ovarian cancer: a clinical study

Human Pathology — Thu, 11 Aug 2011 04:00:00 +0100

In this study, we investigated the prognostic value of metastasis tumor antigen 1 expression in 81 untreated patients with ovarian cancer. The expression of metastasis tumor antigen 1 was evaluated by immunohistochemistry, and staining was analyzed in relation to clinicopathologic variables, disease-free survival, and overall survival. High expression of metastasis tumor antigen 1 was found to be associated with advanced stage (I/II versus III/IV, P = .02) and with worse response to first-line treatment (P = .03). Cases with high metastasis tumor antigen 1 expression showed a lower disease-free survival compared with cases with low expression (P = .02). In multivariate analysis of disease-free survival, metastasis tumor antigen 1 overexpression retained an independent negative prognostic r...

High CD10 expression predicts favorable outcome in surgically treated lymph node–positive bladder cancer patients

Human Pathology — Thu, 11 Aug 2011 04:00:00 +0100

Summary: CD10 predicts survival in different cancers. The prognostic significance in bladder cancer still has to be documented. One hundred fifty lymph node–positive bladder cancer patients were treated by cystectomy and standardized pelvic lymphadenectomy in curative intent. CD10 expression was evaluated in tissue microarrays (TMAs) constructed from histopathological normal urothelium, primary tumor (tumor center and invasion front), and corresponding lymph node metastases and correlated with tumor characteristics (stage, extracapsular extension, number, and total diameter of metastases) and survival. CD10 expression was successively lost from normal urothelium to primary tumor to metastases (P < .05) and decreased from the tumor center to the invasion front (P < .002). High CD10 expres...

Folliculocentric B-cell–rich follicular dendritic cells sarcoma: a hitherto unreported morphological variant mimicking lymphoproliferative disorders

Human Pathology — Thu, 11 Aug 2011 04:00:00 +0100

This study further emphasizes the extreme variability of morphological presentation of FDCS and expands the spectrum of lesions showing a nodular growth pattern occurring in human lymph nodes. (Source: Human Pathology)

Warty/basaloid penile intraepithelial neoplasia is more prevalent than differentiated penile intraepithelial neoplasia in nonendemic regions for penile cancer when compared with endemic areas: a comparative study between pathologic series from Paris and Paraguay

Human Pathology — Thu, 11 Aug 2011 04:00:00 +0100

Summary: Penile squamous cell carcinoma shows an ample geographic variation in its prevalence with regions of low (North America, Europe, Japan, and Israel) and high (Africa, Asia, and South America) incidence. However, the geographic variation in the distribution of penile intraepithelial neoplasia is not well established. The aim of the present study was to compare the distribution of in situ and invasive lesions between geographic areas with low (France) and high (Paraguay) penile cancer incidence using a series of consecutive cases. The French series included 86 cases (57 in situ and 29 in situ + invasive squamous cell carcinoma), and the Paraguayan series, 117 cases (31 in situ and 86 in situ + invasive squamous cell carcinoma). Incidence of invasive squamous cell carcinoma in the ove...

Indeterminate cell tumor of the spleen

Human Pathology — Fri, 05 Aug 2011 04:00:00 +0100

We report a case of indeterminate cell tumor arising from the spleen, a previously unreported site for indeterminate cell tumor. Histologically, the tumor showed nests, nodules, and sheets of large polygonal cells with mostly oval nuclei; open chromatin; variable nucleoli; and abundant, eosinophilic cytoplasm. Some cells possessed irregularly convoluted nuclei with nuclear grooves and granular cytoplasm, suggestive of Langerhans cells. Immunohistochemically, the tumor cells were diffusely positive for S-100 and CD1a and negative for Langerin. No Birbeck granules were found by electron microscopy. Clinical and radiologic examination showed no other organomegaly or lymphadenopathy. A diagnosis of primary indeterminate cell tumor of the spleen was rendered. To the best of our knowledge, this ...

Sensitivity and specificity of finding of multinucleate trophoblastic giant cells in decidua in placentas from high-risk pregnancies

Human Pathology — Fri, 05 Aug 2011 04:00:00 +0100

In conclusion, finding of multinucleate trophoblastic giant cells is not exclusively limited to uteroplacental malperfusion of preeclampsia but is also seen in other types of high-risk pregnancy and in association with other placental hypoxic lesions and patterns. Multinucleate trophoblastic giant cells most likely reflect a premature fusion of extravillous trophoblasts because of several factors, likely including also hypoxia. Being highly specific, finding the multinucleate trophoblastic giant cells is unlikely to give a false-positive result and therefore has high value in retrospectively explaining the perinatal morbidity and mortality. (Source: Human Pathology)

Characteristics of positive surgical margins in robotic-assisted radical prostatectomy, open retropubic radical prostatectomy, and laparoscopic radical prostatectomy: a comparative histopathologic study from a single academic center

Human Pathology — Fri, 05 Aug 2011 04:00:00 +0100

Summary: Studies detailing differences in positive surgical margin among open retropubic radical prostatectomy, laparoscopic radical prostatectomy, and robotic-assisted laparoscopic radical prostatectomy are lacking. A retrospective review of all prostatectomies with positive surgical margin performed at our center in 2007 disclosed 99 cases, 6 (5%) of which were reinterpreted cases as having negative margins. Ninety-three cases were, therefore, included, corresponding to 37 retropubic radical prostatectomies, 19 laparoscopic radical prostatectomies, and 37 robotic-assisted laparoscopic radical prostatectomies. The relationship of positive surgical margin characteristics to clinicopathologic parameters and biochemical recurrence was assessed. The most commonly found positive surgical margi...

Vulvovaginal myofibroblastoma: expanding the morphological and immunohistochemical spectrum. A clinicopathologic study of 10 cases

Human Pathology — Fri, 05 Aug 2011 04:00:00 +0100

Summary: We analyzed the clinicopathologic features of 10 cases of vulvovaginal myofibroblastoma to widen its morphological and immunohistochemical spectrum. Most tumors (8/10 cases) were located in the vagina. The patients' age ranged from 44 to 77 years, and tumor size ranged from 0.4 to 3 cm. Histologically, 5 tumors had the characteristics of vulvovaginal myofibroblastoma. In addition, we identified 3 cases composed of spindle-shaped cells arranged in short fascicles with intervening thick collagen bands, closely reminiscent of mammary myofibroblastoma. Notably, 1 case resembled Sertoli cell tumor, sclerosing type, because of its predominant cord-like arrangement. In another case, there were highly cellular areas composed of uniform-packed, rounded cells that, at low magnification, loo...

Dysplastic lesions in inflammatory bowel disease show increased positivity for the stem cell marker aldehyde dehydrogenase

Human Pathology — Fri, 05 Aug 2011 04:00:00 +0100

Summary: The chronic inflammatory state in patients with inflammatory bowel disease places them at a substantially elevated risk for developing colorectal carcinoma. Moreover, distinguishing an inflammatory phenotype from dysplasia in inflammatory bowel disease can be difficult and has significant patient management implications. To this end, we studied the expression of the cancer stem cell marker aldehyde dehydrogenase to determine whether expression is increased in dysplastic lesions arising in inflammatory bowel disease. We studied 54 patients with inflammatory bowel disease who underwent surgical resection. Of the 54 patients, 13 exhibited high-grade dysplasia or adenocarcinoma, 19 exhibited low-grade dysplasia, and 22 displayed only inflammatory atypia. Staining for aldehyde dehydrog...

Regulatory role of p53 in cancer metabolism via SCO2 and TIGAR in human breast cancer

Human Pathology — Fri, 05 Aug 2011 04:00:00 +0100

Summary: Cancer cells show a higher rate of anaerobic respiration than normal cells. The exact mechanisms for this higher glycolysis rate in cancer cells remain to be elucidated. The results of recent studies have indicated that p53, the most commonly mutated tumor suppressor gene, may have important functions in the regulation of energy-generating metabolic pathways that switch from oxidative phosphorylation to glycolysis via the synthesis of cytochrome c oxidase 2 (SCO2), p53-transactivated TP53-induced glycolysis (TIGAR), and apoptosis regulator. We evaluated the expression of p53, SCO2, TIGAR, and COX in 113 cases of invasive breast cancer using immunohistochemistry. A high expression of p53, SCO2, TIGAR, and COX was noted in 27.5% (31 cases), 84.1% (95 cases), 74.3% (84 cases), and 73...

Anal duct carcinoma: a report of 5 cases

Human Pathology — Fri, 05 Aug 2011 04:00:00 +0100

We describe the clinicopathologic characteristics and follow-up of 5 cases of ADC. Four definitive cases had tissue available for immunohistochemistry (IHC; CK7, CK20, prostate-specific antigen [PSA], estrogen/progesterone receptors [ER/PR], and p16) and in situ hybridization (ISH) for high-risk human papillomavirus (HR-HPV); a fifth case, with a history of ADC, had limited tissue for immunolabeling with only CK7, CK20, and p16. The mean patient age was 69.8 years. All 5 cases were CK7-positive and p16-negative. Four of 5 cases were CK20-negative. All cases with sufficient tissue (4/4) were negative for HR-HPV by ISH, PSA-negative (men), and ER/PR-negative (women). Four of 5 patients had previous malignancies, and in all 4 cases with sufficient tissue, metastasis was excluded with IHC. Of ...

Metallothionein expression in colorectal cancer: relevance of different isoforms for tumor progression and patient survival

Human Pathology — Fri, 05 Aug 2011 04:00:00 +0100

Summary: Metallothioneins are a family of small, cysteine-rich proteins with many functions. Immunohistochemical evaluation of all metallothionein 1 + 2 isoforms in colorectal tumors has demonstrated an important down-regulation compared with normal tissue, although its prognostic significance is unclear. Moreover, the contribution of individual isoforms to overall metallothionein down-regulation is not known. To address these important issues, we analyzed the messenger RNA expression levels of all functional metallothionein 1 + 2 isoforms by quantitative reverse transcription polymerase chain reaction in 22 pairs of normal and tumor-microdissected epithelia and correlated these to the overall immunohistochemical protein expression. Our results showed that 5 isoforms (MT1G, 1E, 1F, 1H, and...

Fluorescence in situ hybridization mapping of esophagectomy specimens from patients with Barrett's esophagus with high-grade dysplasia or adenocarcinoma

Human Pathology — Fri, 05 Aug 2011 04:00:00 +0100

Summary: The progression of intestinal metaplasia to esophageal adenocarcinoma in patients with Barrett's esophagus is partly driven by chromosomal alterations that activate oncogenes and inactivate tumor suppressor genes. The goal of this study was to determine how alterations of 4 frequently affected genes correlate with the range of histopathologic lesions observed in resected esophagi of patients with Barrett's esophagus. Fluorescence in situ hybridization was used to assess 83 tissue sections from 10 Barrett's esophagus esophagogastrectomy specimens for chromosomal alterations of 8q24 (MYC), 9p21 (CDKN2A; alias P16), 17q12 (ERBB2), and 20q13.2 (ZNF217). Histologic lesions assessed included gastric metaplasia (n = 8), intestinal metaplasia (n = 43), low-grade dysplasia (n = 28), high-g...

High-grade papillary urothelial carcinoma of the urinary tract: a clinicopathologic analysis of a post–World Health Organization/International Society of Urological Pathology classification cohort from a single academic center

Human Pathology — Fri, 05 Aug 2011 04:00:00 +0100

In conclusion, recurrence, progression, and cancer-specific mortality rates were 36.5%, 40%, and 15%, respectively. All the patients who died of cancer had a history of tumor progression. Patients with recurrences showed similar outcomes to those with no recurrence. Tumor size was strongly associated with tumor progression and cancer-specific survival, whereas clinical stage was significantly associated with outcome in the progression group. In light of the high recurrence and progression rates of high-grade papillary urothelial carcinoma, strict clinical surveillance aimed to detect early recurrent lesions, especially in patients with larger tumors, is warranted. (Source: Human Pathology)

Pediatric adrenocortical tumors: morphological diagnostic criteria and immunohistochemical expression of matrix metalloproteinase type 2 and human leucocyte-associated antigen (HLA) class II antigens: Results from the Italian Pediatric Rare Tumor (TREP) Study project

Human Pathology — Fri, 05 Aug 2011 04:00:00 +0100

Summary: Pediatric adrenocortical tumors are neoplasms that only rarely occur in pediatric patients. Their clinical behavior is often unpredictable, and the histologic criteria of malignancy used in adults are not always useful in children. The aim of this study was to validate the prognostic value of the pathologic criteria of Wieneke et al and to evaluate the potential prognostic expression of matrix metalloproteinase 2 and human leucocyte-associated antigen (HLA) class II antigens in a series of 20 pediatric patients affected by adrenocortical tumors, who were enrolled in the Italian Pediatric Rare Tumor (TREP) Study between 2000 and 2007. The age range was 0 to 17.5 years (mean, 7.28 years) with a male-female ratio of 1:2. The mean follow-up was 64.4 months. The histologic diagnoses we...

Signet ring cell tumor of the minor salivary gland exhibiting benign behavior

Human Pathology — Wed, 03 Aug 2011 04:00:00 +0100

Summary: Signet ring cell (SRC) carcinomas are usually aggressive malignancies, arising most frequently in the stomach and gastrointestinal tract, but also, although less often, in other organs such as the breast, bladder, and lungs. They are particularly unusual in the salivary glands, and the aim of the present study is to report a case of a tumor of the minor salivary glands of the lower lip composed largely of SRCs but which displayed benign clinical behavior. (Source: Human Pathology)

The CIC-DUX4 fusion transcript is present in a subgroup of pediatric primitive round cell sarcomas

Human Pathology — Wed, 03 Aug 2011 04:00:00 +0100

Summary: Pediatric undifferentiated soft tissue sarcomas are a group of diagnostically challenging tumors. Recent studies have identified a subgroup of undifferentiated soft tissue sarcomas with primitive round to plump spindle cell morphology and a t(4;19)(q35;q13.1) translocation resulting in the expression of a CIC-DUX4 fusion transcript, including 2 tumors previously reported by our laboratory (Cancer Genet Cytogenet 2009;195:1). In the present study, reverse transcriptase polymerase chain reaction assays developed for both frozen and paraffin-based tissues were applied to a series of 19 pediatric undifferentiated soft tissue sarcomas using a combination of primer sets covering the CIC-DUX4 fusion transcript. Of the 19 undifferentiated soft tissue sarcomas, 16 had primitive round to pl...

Myoid gonadal stromal tumor: a distinct testicular tumor with peritubular myoid cell differentiation

Human Pathology — Wed, 03 Aug 2011 04:00:00 +0100

We report a distinct, primary testicular tumor with peritubular myoid cell differentiation. A 25-year-old man developed a well-circumscribed testicular tumor composed of cytologically bland spindled cells, which were strongly and diffusely positive for desmin, smooth muscle actin, muscle-specific actin, and smooth muscle myosin. In addition, S-100 was diffusely positive, and cytokeratin (CK5/6 and AE1/3) was focally positive. Calretinin, inhibin, and CD34 were all negative. This pattern of immunoreactivity was very similar to the normal adjacent peritubular myoid cells. Follow-up after radical orchiectomy showed benign behavior. We found reports of 6 similar intratesticular tumors demonstrating peritubular myoid cell–like differentiation and having favorable outcome. We believe that the ...

Ectomesenchymoma with t(1;12)(p32;p13) evolving from embryonal rhabdomyosarcoma shows no rearrangement of ETV6

Human Pathology — Mon, 01 Aug 2011 04:00:00 +0100

Summary: Ectomesenchymoma is a rare mesenchymal malignancy occurring mainly in the pediatric population. The hallmark diagnostic features are a combination of sarcoma, usually rhabdomyosarcoma (RMS) with admixed ganglion cells. The lesion arises either in soft tissues or the cranial cavity, and outcomes vary considerably. Current knowledge about the genetics and biology of ectomesenchymoma is extremely limited with only 4 published karyotypes, showing overlaps only in trisomies 2, 8, and 11. Here, we describe a case with genetic findings that, in conjunction with preexisting observations, offer some additional insights into the genetic aberrations of ectomesenchymoma. (Source: Human Pathology)

Tumor of the heart in a young woman; a rare manifestation of Wegener granulomatosis

Human Pathology — Mon, 01 Aug 2011 04:00:00 +0100

We report a case of a 19-year-old woman with no prior significant medical history who presented with persistent ventricular tachycardia and a papillary muscle mass in her left ventricle which upon excision and tissue evaluation demonstrated histologic changes of Wegener granulomatosis. (Source: Human Pathology)

Immunoreactivity to caspase-3, caspase-7, caspase-8, and caspase-9 forms is frequently lost in human prostate tumors

Human Pathology — Fri, 29 Jul 2011 04:00:00 +0100

Summary: Caspases are essential initiators and executioners of apoptosis. Changes in their expression may contribute to the development of proliferative disorders such as cancer, by altering the death-proliferation homeostatic balance. The aim of this work was to analyze the expression of a broad panel of caspases at the epithelial level in human prostate tissues to assess possible prostatic disease–related alterations. We comparatively analyzed by immunohistochemistry the expression of pro–caspase-3, pro–caspase-8, pro–caspase-9, cleaved caspase-3, cleaved caspase-8, and caspase-7, in normal and pathologic (benign hyperplasic, premalignant [high-grade intraepithelial neoplasia], and cancerous [prostate cancer]) human prostate epithelium. Expression of caspases was correlated with ...

Overexpression of optic atrophy 1 protein increases cisplatin resistance via inactivation of caspase-dependent apoptosis in lung adenocarcinoma cells

Human Pathology — Thu, 28 Jul 2011 04:00:00 +0100

In conclusion, optic atrophy 1 is highly expressed in lung adenocarcinoma and indicates poor prognosis. (Source: Human Pathology)

Erratum to “Cytogenetic and molecular aberrations in endometrial stromal tumors” (Hum Pathol 2011;42:609-617)

Human Pathology — Thu, 28 Jul 2011 04:00:00 +0100

The aforementioned authors have noted that reference number in their article cites the wrong reference information. The correct reference appears below. (Source: Human Pathology)

Relationship between amyloid deposition and intracellular structural changes in familial amyloidotic polyneuropathy

Human Pathology — Thu, 21 Jul 2011 04:00:00 +0100

Summary: Transthyretin-related familial amyloidotic polyneuropathy is a systemic amyloidosis caused by mutations in the transthyretin gene. Extracellular deposition of amyloid is the common pathologic hallmark of amyloidoses including Alzheimer disease, AL amyloidosis, AA amyloidosis, and familial amyloidotic polyneuropathy. However, the exact relationship between amyloid deposition and cell death has not yet been clarified. To elucidate this relationship, we studied the effect of transthyretin amyloid fibrils and prefibrillar aggregates on cells by using autopsy tissues obtained from 8 patients with familial amyloidotic polyneuropathy, as well as cultured cell lines. Ultrastructural studies of amyloid-laden cardiomyocytes showed that intracellular structural changes correlated with the de...

Immunohistochemical markers of tissue injury in biopsies with transplant glomerulitis

Human Pathology — Thu, 21 Jul 2011 04:00:00 +0100

In conclusion, glomerular injury in transplant glomerulitis appears to be mediated by complement activation and cellular cytotoxicity. Mesangial– or interstitial–von Willebrand factor identified cases with more severe microcirculation injury. (Source: Human Pathology)

Decreased Beclin-1 expression is correlated with the growth of the primary tumor in patients with squamous cell carcinoma and adenocarcinoma of the lung

Human Pathology — Thu, 21 Jul 2011 04:00:00 +0100

Summary: Beclin-1 is a Bcl-2–interacting protein, and it may delay cell cycle progression and induce autophagy. The function and expression of Beclin-1 and Bcl-2 in squamous cell carcinoma and adenocarcinoma of the lung remain largely unknown. Herein, we investigated the expression of Beclin-1 and Bcl-2 in squamous cell carcinoma and adenocarcinoma of the lung. Tissue samples from 262 cases were used in this study. Immunohistochemical staining for Beclin-1 and Bcl-2 were conducted using a tissue microarray. In squamous cell carcinoma, Beclin-1 expression was strongly positive in 48 (28.6%) of 168 samples, it was moderately positive in 42 (25.0%) of 168 samples, and it was negative or weakly positive in 78 (46.4%) of 168 samples. In adenocarcinoma, Beclin-1 expression was strongly positiv...

Detection of hepatitis B virus DNA in paraffin-embedded intrahepatic and extrahepatic cholangiocarcinoma tissue in the northern Chinese population

Human Pathology — Thu, 21 Jul 2011 04:00:00 +0100

This study explored the importance of hepatitis B virus infection in cholangiocarcinoma pathogenesis in northern China. The clinical data of 66 patients with cholangiocarcinoma were analyzed. The hepatitis B virus gene was amplified using nested polymerase chain reaction, and the hepatitis B virus–related antigen was detected using immunohistochemistry in formalin-fixed, paraffin-embedded tissue from patients with intrahepatic cholangiocarcinoma (n = 23) and extrahepatic cholangiocarcinoma (n = 43). Hepatitis B surface antigen seropositivity was found in 52.2% (12/23) of intrahepatic cholangiocarcinoma cases and 13.9% (6/43) of extrahepatic cholangiocarcinoma cases. Hepatitis B virus DNA (X region) was detectable in 34.8% (8/23) of intrahepatic cholangiocarcinoma cases. Hepatitis B surfa...

Prognostic significance of Bcl-2 in invasive mammary carcinomas: a comparative clinicopathologic study between “triple-negative” and non–“triple-negative” tumors

Human Pathology — Thu, 21 Jul 2011 04:00:00 +0100

In conclusion, there are major clinicopathologic differences between breast cancer phenotypes. Our results establish the value of using Bcl-2 in prognostic stratification of patients and its potential therapeutic implications in selecting patients for treatment. (Source: Human Pathology)

Incidence of human papillomavirus in oropharyngeal squamous cell carcinomas: now and 50 years ago

Human Pathology — Thu, 21 Jul 2011 04:00:00 +0100

This study provides the earliest historic baseline for human papillomavirus incidence in oropharyngeal squamous cell carcinoma and may serve as a reference point for evaluating the results of human papillomavirus infection preventive measures, such as human papillomavirus vaccination. (Source: Human Pathology)

Intraductal papillary mucinous neoplasm

Human Pathology — Thu, 21 Jul 2011 04:00:00 +0100

Summary: Intraductal papillary mucinous neoplasm (IPMN) is a grossly visible (≥1 cm), mucin-producing neoplasm that arises in the main pancreatic duct and/or its branches. Patients with intraductal papillary mucinous neoplasm can present with symptoms caused by obstruction of the pancreatic duct system, or they can be asymptomatic. There are 3 clinical subtypes of intraductal papillary mucinous neoplasm: main duct, branch duct, and mixed. Five histologic types of intraductal papillary mucinous neoplasm are recognized: gastric foveolar type, intestinal type, pancreatobiliary type, intraductal oncocytic papillary neoplasm, and intraductal tubulopapillary neoplasm. Noninvasive intraductal papillary mucinous neoplasms are classified into 3 grades based on the degree of cytoarchitectural atyp...

Fluorescence in situ hybridization for detection of MAML2 rearrangements in oncocytic mucoepidermoid carcinomas: utility as a diagnostic test

Human Pathology — Thu, 21 Jul 2011 04:00:00 +0100

Summary: Oncocytic mucoepidermoid carcinoma poses diagnostic challenge because of its histologic overlap with other oncocytic salivary gland lesions, including Warthin tumor. Although the prognostic value of the t(11;19) MECT1-MAML2 fusion gene has been established in mucoepidermoid carcinoma, its diagnostic use in discriminating oncocytic mucoepidermoid carcinoma from histologic mimics is unexplored. We evaluated the translocation status in 14 cases of oncocytic mucoepidermoid carcinoma using a MAML2-11q21 break-apart probe spanning the entire chromosome region of the MAML2 gene and correlated these findings with clinicopathologic parameters including age, sex, stage, predominant growth pattern, grade, and p63 immunostaining pattern. All oncocytic mucoepidermoid carcinomas were parotid tu...

Papillary urothelial neoplasm of low malignant potential of the urinary bladder: clinicopathologic and outcome analysis from a single academic center

Human Pathology — Thu, 21 Jul 2011 04:00:00 +0100

In conclusion, recurrences were observed in 42% of all our patients, with a grade progression rate of 29%. None of our patients developed invasive carcinoma or died as a consequence of their disease. Considering the low but definitive risk of recurrence and grade progression, appropriate clinical follow-up of patients with primary papillary urothelial neoplasm of low malignant potential is warranted. (Source: Human Pathology)

Intravenous leiomyomatosis of the uterus: A clinicopathologic study of 18 cases, with emphasis on early diagnosis and appropriate treatment strategies

Human Pathology — Wed, 20 Jul 2011 23:00:00 +0100

Summary: Intravenous leiomyomatosis is a rare variant of leiomyoma that could result in death. Early and accurate diagnosis and appropriate treatment strategies play a dominant role in good prognosis. Eighteen cases of Intravenous leiomyomatosis , along with clinicopathologic data, were retrieved from our database. Most of the patients who ranged in age from 33 to 54 years (median, 44 years) presented with a pelvic mass or abnormal uterine bleeding. The diagnosis was confirmed by a immunohistochemical staining for smooth muscle actin, CD34, and Ki67. Surgical exploration confirmed the presence of a uterine mass (mean size, 5.08 cm). Wormlike plugs were identified within the broad ligament in 5 cases. The tumor penetrated to the inferior vena cava in 1 case. Histologic variants were noted i...

BRAFV600E mutation analysis of liquid-based preparation–processed fine needle aspiration sample improves the diagnostic rate of papillary thyroid carcinoma

Human Pathology — Wed, 20 Jul 2011 04:00:00 +0100

Summary: Early detection and diagnosis of papillary thyroid carcinoma are important for successful management of patients. Liquid-based preparations (Thinprep) of fine needle aspirations from thyroid nodules are now widely used and are replacing conventional smears because residual samples can be used for ancillary tests. Detection of the BRAFV600E mutation in cytology specimens could aid in the diagnosis of papillary thyroid carcinoma. We, therefore, analyzed the cytologic features and BRAFV600E mutation status of thyroid liquid-based preparation–fine needle aspiration samples. A total of 191 histologically confirmed thyroid liquid-based preparation–fine needle aspiration specimens were selected. We analyzed cytomorphological features and BRAFV600E mutation status in both liquid-based...

In This Issue August 2011

Human Pathology — Sun, 17 Jul 2011 03:16:30 +0100

(Source: Human Pathology)

Human Pathology — Sun, 17 Jul 2011 03:16:30 +0100

(Source: Human Pathology)

Information for Authors

Human Pathology — Sun, 17 Jul 2011 03:16:30 +0100

(Source: Human Pathology)

Editorial Board

Human Pathology — Sun, 17 Jul 2011 03:16:30 +0100

(Source: Human Pathology)

Masthead

Human Pathology — Sun, 17 Jul 2011 03:16:29 +0100

(Source: Human Pathology)

In situ follicular lymphoma with progressive transformation of the germinal centers confirmed by laser capture microdissection, IGH gene rearrangement analysis, and fluorescence in situ hybridization for t(14;18)